A 16-year-old south Asian male presented with a four year history of right proptosis with a supero-anterior soft tissue mass and similar cheek swellings. The lesions have increased in size and the overlying skin is pruritic. He was otherwise healthy, but with a tendency towards atopy (allergies). There was no relevant family history, no recent travel history, and all routine vaccinations were up to date.

1.

What investigations would you perform for this patient?

a.

MRI of the orbits

b.

blood tests

c.

Mantoux test

d.

fluorescein angiography

e.

(a), (b), and (c)

2.

Decision to do a biopsy would be based on the following findings:

a.

soft tissue mass

b.

eosinophilia

c.

fluorescein angiography

d.

(a) and (b)

e.

(a), (b), and (c)

3.

The tissue sample on histologic examination demonstrated an area of eosinophilic microabscess in a germinal center of a lymphoid nodule. This suggests a diagnosis of: